by Mithran Samuel
Adult social care has re-emerged in recent years as a political issue of some salience. The story count on the sector in the national press has picked up notably (with indignity in care and the prospect that care fees will drain people of their savings and rob them of their homes being the topics of choice), while the BBC carried an entire month of programmes on the issue in January. Meanwhile, the Department of Health’s focus on adult care has increased significantly through the personalisation agenda and its work towards this year’s green paper, which promises to address the knotty question of funding. But how far do our media and political friends see adult social care as older people’s social care and what is younger, disabled people’s place in this new world?Marginalised from the debate
In Community Care today, John Knight, head of policy and campaigns at Leonard Cheshire Disability, suggests that disabled people have been marginalised from the debate on funding (though, he stresses, not the personalisation agenda), and it is hard not to agree with him.
The Wanless report, which has set the terms of the political debate on funding, was solely about older people. Indeed, when the Liberal Democrats backed its blueprint for funding care – the partnership model – in January, the party said this would only apply to people over 65. I recently heard that the government had intended for this year’s green paper to focus on older people and not all adults and changed its mind just before its announcement in last year’s comprehensive spending review.
More broadly, the burgeoning public debate on the issue has focused squarely on older people – whether through newspaper stories on abusive care situations or the impact of care fees on savings, or countless polls asking the public how they think they should pay for their future care needs.
The focus on older people is laudable, given the group’s past neglect. It is also understandable from several perspectives. According to latest government figures, 83% of adult care users are aged over 65. Moreover, the universality of age and the now broad understanding that the population is ageing provide a useful lens to look at a traditionally marginalised issue such as adult social care.
Disability and unemployment
However, this focus could be pernicious, and not just because the parallel personalisation agenda is based on the principle that the social care system should be able to meet the needs of each and every user.
One of this government’s proudest achievements is breaking the link between older age and poverty. But as Knight points out, disabled people are twice as likely to be poor as non-disabled people and much more likely to be unemployed. Many older people, by contrast, will have entered the social care system after a lifetime of work, and having built up assets. Thus any debate that focuses on how and whether savings or equity should be used to pay for care – or how much individuals should contribute generally – risks freezing disabled people out of the picture.
And, given the current state of the public finances and the deep unlikelihood of the government arguing that taxes should rise to fund care, any solution to the funding problem that puts an added onus on individual contributions (or at least makes this effectively the condition of high-quality services) could seriously backfire on poorer, disabled people.
Increasing life expectancy
Demographic change is multi-faceted. The increasing life expectancy of disabled people at all ages is a big part of the picture – as much as the rising number of older people more generally.
Obviously, there are common interests between older and disabled service users. For instance, as Help the Aged points out, most people with sensory impairments are older people, while pensioner poverty remains a large problem, with an estimated £4.5bn in unclaimed benefits.
You would hope this would encourage some coalition-building across the voluntary sector, rather than client group-based divisions. But it must also inform the government’s approach so that we get the green paper we deserve – one that provides a fair and lasting settlement for all those who require social care services, and not just most of them.